Lung transplantation in cystic fibrosis patients in Israel: The importance of ethnicity and nutritional status

Objectives: To assess the characteristics that correlate with better outcomes after lung transplantation for patients with cystic fibrosis (CF). Methods: We retrospectively reviewed the charts of all patients with CF who underwent lung transplantation between 1996 and 2014 at Rabin Medical Center, Israel. Results: Fifty patients with CF underwent 55 lung transplantations. Eighteen patients (36%) died during the study period. Actuarial survival was 83%, 68%, 62%, and 39% at 1, 3, 5, and 10 years, respectively. Better survival correlated with: BMI at 6 months and 1 year after transplantation (P =.002 and P =.003, respectively), ischemic time of less than 300 minutes (P =.023), absence of liver disease (P =.012), and Jewish compared to Arab ethnicity (P =.007). Freedom from bronchiolitis obliterans syndrome (BOS) was 87%, 75%, and 72% at 1, 3, and 5 years, respectively. BOS was more common and appeared earlier in the Arab than in the Jewish population (P =.012, P =.007). Additionally, prolonged time free of BOS correlated with male gender (P =.039), older age (P <.001), absence of liver disease (P =.012), and higher BMI 1 year after transplantation (P <.001). Conclusions: Clinically important determinants for survival include BMI pre- and 1-year post-transplantation and improved freedom from BOS. Arab ethnicity correlated with higher incidence and earlier onset of BOS compared to Jewish ethnicity in Israel.